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Real word challenges in integrating electronic medical record and administrative health data for regional quality improvement in diabetes: a retrospective cross-sectional analysis

BACKGROUND: Linked electronic medical records and administrative data have the potential to support a learning health system and data-driven quality improvement. However, data completeness and accuracy must first be assessed before their application. We evaluated the processes, feasibility, and limi...

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Autores principales: Swaleh, Rukia, McGuckin, Taylor, Campbell-Scherer, Denise, Setchell, Brock, Senior, Peter, Yeung, Roseanne O.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9806899/
https://www.ncbi.nlm.nih.gov/pubmed/36593483
http://dx.doi.org/10.1186/s12913-022-08882-7
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author Swaleh, Rukia
McGuckin, Taylor
Campbell-Scherer, Denise
Setchell, Brock
Senior, Peter
Yeung, Roseanne O.
author_facet Swaleh, Rukia
McGuckin, Taylor
Campbell-Scherer, Denise
Setchell, Brock
Senior, Peter
Yeung, Roseanne O.
author_sort Swaleh, Rukia
collection PubMed
description BACKGROUND: Linked electronic medical records and administrative data have the potential to support a learning health system and data-driven quality improvement. However, data completeness and accuracy must first be assessed before their application. We evaluated the processes, feasibility, and limitations of linking electronic medical records and administrative data for the purpose of quality improvement within five specialist diabetes clinics in Edmonton, Alberta, a province known for its robust health data infrastructure. METHODS: We conducted a retrospective cross-sectional analysis using electronic medical record and administrative data for individuals ≥ 18 years attending the clinics between March 2017 and December 2018. Descriptive statistics were produced for demographics, service use, diabetes type, and standard diabetes benchmarks. The systematic and iterative process of obtaining results is described. RESULTS: The process of integrating electronic medical record with administrative data for quality improvement was found to be non-linear and iterative and involved four phases: project planning, information generating, limitations analysis, and action. After limitations analysis, questions were grouped into those that were answerable with confidence, answerable with limitations, and not answerable with available data. Factors contributing to data limitations included inaccurate data entry, coding, collation, migration and synthesis, changes in laboratory reporting, and information not captured in existing databases. CONCLUSION: Electronic medical records and administrative databases can be powerful tools to establish clinical practice patterns, inform data-driven quality improvement at a regional level, and support a learning health system. However, there are substantial data limitations that must be addressed before these sources can be reliably leveraged. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-08882-7.
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spelling pubmed-98068992023-01-03 Real word challenges in integrating electronic medical record and administrative health data for regional quality improvement in diabetes: a retrospective cross-sectional analysis Swaleh, Rukia McGuckin, Taylor Campbell-Scherer, Denise Setchell, Brock Senior, Peter Yeung, Roseanne O. BMC Health Serv Res Research BACKGROUND: Linked electronic medical records and administrative data have the potential to support a learning health system and data-driven quality improvement. However, data completeness and accuracy must first be assessed before their application. We evaluated the processes, feasibility, and limitations of linking electronic medical records and administrative data for the purpose of quality improvement within five specialist diabetes clinics in Edmonton, Alberta, a province known for its robust health data infrastructure. METHODS: We conducted a retrospective cross-sectional analysis using electronic medical record and administrative data for individuals ≥ 18 years attending the clinics between March 2017 and December 2018. Descriptive statistics were produced for demographics, service use, diabetes type, and standard diabetes benchmarks. The systematic and iterative process of obtaining results is described. RESULTS: The process of integrating electronic medical record with administrative data for quality improvement was found to be non-linear and iterative and involved four phases: project planning, information generating, limitations analysis, and action. After limitations analysis, questions were grouped into those that were answerable with confidence, answerable with limitations, and not answerable with available data. Factors contributing to data limitations included inaccurate data entry, coding, collation, migration and synthesis, changes in laboratory reporting, and information not captured in existing databases. CONCLUSION: Electronic medical records and administrative databases can be powerful tools to establish clinical practice patterns, inform data-driven quality improvement at a regional level, and support a learning health system. However, there are substantial data limitations that must be addressed before these sources can be reliably leveraged. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-08882-7. BioMed Central 2023-01-02 /pmc/articles/PMC9806899/ /pubmed/36593483 http://dx.doi.org/10.1186/s12913-022-08882-7 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Swaleh, Rukia
McGuckin, Taylor
Campbell-Scherer, Denise
Setchell, Brock
Senior, Peter
Yeung, Roseanne O.
Real word challenges in integrating electronic medical record and administrative health data for regional quality improvement in diabetes: a retrospective cross-sectional analysis
title Real word challenges in integrating electronic medical record and administrative health data for regional quality improvement in diabetes: a retrospective cross-sectional analysis
title_full Real word challenges in integrating electronic medical record and administrative health data for regional quality improvement in diabetes: a retrospective cross-sectional analysis
title_fullStr Real word challenges in integrating electronic medical record and administrative health data for regional quality improvement in diabetes: a retrospective cross-sectional analysis
title_full_unstemmed Real word challenges in integrating electronic medical record and administrative health data for regional quality improvement in diabetes: a retrospective cross-sectional analysis
title_short Real word challenges in integrating electronic medical record and administrative health data for regional quality improvement in diabetes: a retrospective cross-sectional analysis
title_sort real word challenges in integrating electronic medical record and administrative health data for regional quality improvement in diabetes: a retrospective cross-sectional analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9806899/
https://www.ncbi.nlm.nih.gov/pubmed/36593483
http://dx.doi.org/10.1186/s12913-022-08882-7
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